Post-licensing visit·July 15, 2024

Unannounced Post Licensing visit made out to this facility on 07/15/2024 by Licensing Program Analyst (LPA) Charlie Yang. This LPA was met by the facility designated Administrator, Oliver Flores, who was briefly interviewed at this time. Current census was 1 resident. It was learned that there weren't any residents under the care of hospice at this time. This facility does have an approved waiver to be able to accept and retain up to (6) residents under the care of hospice at any given time. It was learned that this facility has a program to be able to accept and retain dementia residents at any given time. It was learned that there weren't any residents diagnosed with dementia at this time. It was learned that there was (1) resident receiving services through home health at this time. Tour of this facility was conducted. Dining area, living area, and all other areas intended for resident use were toured. Furniture and furnishings were observed to be sufficient and able to meet the needs of the residents at this time. Linen closet, located in facility entryway, was reviewed and observed to contain a sufficient supply of towels, sheets, and bedding able to meet the needs of the residents at this time. Kitchen area was toured. Kitchen drawers and cabinets were opened and reviewed. Food supply for 2-day perishable and 7-day nonperishable quantities was reviewed to make sure that they were in compliance at all times. Laundry area, located in the facility hallway leading into the garage area, was toured. Bleach, detergent, and all other cleaning supplies were observed to be locked and made inaccessible to the residents at this time. Administrator certificate, #6065720740, for Oliver Flores was observed to have an expiration date of 01/18/2025 and in compliance at this time. Medication cabinet, located in the facility kitchen area, was observed to be locked and made inaccessible to the residents at this time. First aid kit, located adjacent to the kitchen area, was reviewed. This LPA observed that it did contain all of the required components at this time. Fire extinguisher, located in the facility entryway hallway, was observed to have been annually purchased on 09/16/2023 and in compliance at this time. Facility resident bedrooms were toured. Furniture and furnishings were observed to be sufficient and able to meet the needs of the residents at this time. Facility resident restrooms were toured. Grab bars and non skid mats were observed to be present and in good repair at this time. Hot water temperatures were taken to make sure that they were within the allowed range of 105-120 degrees. A tour of the facility exterior grounds was conducted. A review of the facility perimeter fence, side gates, and all other exits was conducted. This LPA observed additional storage sheds that were present on the east side of this facility at this time. The storage sheds were observed to be locked and made inaccessible to the residents at this time. A review of (2) facility personnel records was conducted and noted on the following LIC 859. A review of (1) facility resident record was conducted and noted on the following LIC 858. The following deficiencies were observed and cited on the following LIC 809-D pursuant to Title 22 Rules and Regulations, Health and Safety Codes. Appeal rights were printed and a copy was given to the facility designated Administrator at this time. Exit Interview